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number 902156990] Publisher Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
Journal of Sex & Marital Therapy
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Modifying Sensate Focus for Use with Haredi (Ultra-Orthodox) Jewish Couples
David S. Ribner a a School of Social Work, Bar-Ilan University, Ramat Gan, Israel. Online Publication Date: 01 March 2003
To cite this Article Ribner, David S.(2003)'Modifying Sensate Focus for Use with Haredi (Ultra-Orthodox) Jewish Couples',Journal of
Sex & Marital Therapy,29:2,165 — 171
To link to this Article: DOI: 10.1080/713847171 URL: http://dx.doi.org/10.1080/713847171
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E-mail: matzeel@hotmail. The perceptual conflict of whether sex is “good” or “bad” and the behavioral challenge of shifting from absolute celibacy to sexual union have been recorded in the professional literature (Jehu. 1993). 1970. This article examines inherent challenges that occur when using aspects of sensate focus with Haredi Jewish couples as a result of adherence to traditional rules defining and influencing intimate behavior and suggests treatment alternatives for clients of this population. 1992. Ribner.00 + . RIBNER School of Social Work.00 DOI: 10. 2003 Copyright © 2003 Brunner-Routledge 0092-623X/03 $12. Simpson & Ramberg. Israel 52900. Address correspondence to David S. Masters & Johnson. 2000. Israel Downloaded By: [EBSCOHost EJS Content Distribution] At: 12:11 12 March 2009 Marital and sex therapists have long recognized the role that religion may play in the etiology of sexual dysfunction. Bar-Ilan University. 29(2):165–171. Marital and sex therapists have long recognized the role that religious beliefs may play in the etiology of sexual dysfunction (Bullis & Harrigan. Considerably less attention has been paid to religious standards for sexual conduct as a couple’s voluntarily accepted behavioral context. Ramat Gan. This article examines the use of aspects of sensate focus with Haredi Jewish couples and the inherent clinical challenges resulting from their adherence to traditional rules defining and influencing intimate behavior. Working in accord with such belief systems may necessitate creative modifications of treatment protocols in order to maximize potential for change while minimizing immutable sources of resistance. 1992). School of Social Work. Considerably less attention has been paid to religious standards for sexual conduct as a couple’s voluntarily accepted behavioral context.1080/00926230390155050 Modifying Sensate Focus for Use with Haredi (Ultra-Orthodox) Jewish Couples DAVID S. 1987). which substantially defines the therapeutic framework (Burt & Rudolph. Ramat Gan. 1979.com 165 . A therapist working in accord with such belief systems may require creative modifications of treatment protocols to maximize potential for change while minimizing sources of resistance. Bar-Ilan University.Journal of Sex & Marital Therapy. Parrinder. Simpson & Ramberg.
which leads to the need to sanctify all aspects of daily life. Ribner THE HAREDIM The word haredi (plural: haredim) means God fearing and refers to those within the Jewish community whose lives are governed by scrupulous observance of Jewish law in order to come closer to God (the term “UltraOrthodox” is often used to refer to this population). Judaism understands marriage as fulfilling two equally important functions: procreation and human completion. Ostrov. • Central values of marriage and large families. including social and occupational interactions. family. Linzer. 18) is understood not as sage advice but as part of the blueprint for creation (Soloveitchik. • Professional help for personal. wherever possible. as manifest in the mutual obligation to provide sexual pleasure. • Relatively specific gender role expectations. This latter point means that single adults are viewed as essentially unfinished. with only life or death situations permitting any deviance. Sexual expression is exclusive to the marital relationship and is essential to the physical and spiritual well-being of both partners. resulting in higher levels of spirituality. II. Any deviation from Divinely ordained Biblical requirements generally is unacceptable. • Daily prayer and study of religious texts. with wholeness coming only through the partnership afforded by marriage. S. The focus is not on asceticism. but rather a belief in God’s active involvement with humanity. particularly for males. 1997. or communal problems that must conform to religious guidelines. the emphasis is placed on stricter rather than more lenient legal interpretations. The following are common to all Haredim: Downloaded By: [EBSCOHost EJS Content Distribution] At: 12:11 12 March 2009 • Modes of dress that are modest and tend to be uniform. • Gender-segregated educational institutions starting from pre-school. 1970. The Biblical phrase “It is not good for man to live alone” (Genesis. • Strict prohibition of male-female physical contact before marriage and explicit rules governing contact after marriage. 1978) and will be discussed here only briefly.166 D. 2000). and forced sexual contact is expressly forbid- . which are more communal for men than for women. SEXUALITY IN TRADITIONAL JEWISH MARRIAGE Sexuality in traditional Jewish marriage has been well documented (Friedman. • Living in Haredi neighborhoods and. Withholding of physical intimacy is grounds for divorce. making use of exclusively Haredi communal institutions.
Modifying Sensate Focus 167 Downloaded By: [EBSCOHost EJS Content Distribution] At: 12:11 12 March 2009 den. THE USE OF SENSATE FOCUS According to Kaplan’s (1974) definition. as will be noted below. Although the rabbi’s primary operating principle will be the couple’s sexual compatibility and satisfaction. a dearth of adequately trained therapists has proven an impediment to those desiring access to trustworthy professionals. their wives. Traditionally. 8) is understood by the Haredim as a principle applicable to almost every aspect of daily life. However. The exercises. It should be noted here that this tenet does not mandate sexual intercourse through a hole in a sheet. Using sensate . carried out with both partners naked and in a relaxed state. Modesty The biblical phrase “and you shall walk in modesty with your God” (Micah. However. fits well with this technique. combined with cultural imperatives such as modesty in all realms of human behavior. this gap has been filled by various communal functionaries. he may require modification of specific treatment suggestions to conform to religious dicta. Sensate focus encourages an openness—physically and emotionally— that can be perceived as antagonistic to the value of modesty. which pervasively influence Haredi sexual norms. at its own pace. A condition of sex therapy with Haredim is that the couple may consult a rabbinic authority at any or all stages of treatment. Although modesty in dress is the most recognizable manifestation of this standard. The lack of premarital sexual experience for almost all of this population. Sensate focus with Haredi couples has the potential to be a particularly effective therapeutic tool. As the general public has become more attuned to definitions of sexual dysfunctions and options for treatment. which can be adapted easily to cultural expectations and client comfort level. although time plays an important role. and visual interaction and that is designed to achieve an enhanced level of physical pleasure without any expectation of performance or the need to reach orgasm. an example of erroneous “common knowledge” frequently ascribed to this religious population. such as rabbis. paraprofessional premarital advisors for both men and women. so. has the Haredi community. sensate focus is a two-step interventive model that emphasizes tactile. VI. it has relevance as well to a couple’s intimate life. should be taken into account at the outset of the treatment process. emphasize sensory selfawareness by each participant and the transmission of knowledge of these feelings to the partner. four factors. verbal. Jewish law has relatively little to say about actual sexual activity between marital partners. and more recently.
when the invocation of modesty serves a dynamic rather than sacred function.168 D. This can be accomplished by beginning with both partners wearing familiar night clothing and pleasuring each other using only back massage. the therapist should consider a more graduated version of sensate focus that is specific to each couple and designed to maintain a sense of modesty and to avoid sensory overload. Observance of these “Laws of Family Purity” is considered an inviolate and integral aspect of identity as an Orthodox Jew. the sequential nature of sen- . Progressive stages can move from nongenital front massage to unclothed-to-the-waist back massage to fully naked back massage. as an example. This “2 weeks on/2 weeks off” pattern of contact characterizes marital life until menopause. It encourages the couple to engage in nonsuggestive conversation and physical distancing. and the therapist should legitimize the awkwardness of the couple’s physical and emotional self-revelation. However. and so forth. with two notable time frame exceptions—pregnancy and nursing (until postpartum menstruation resumes)—when uninterrupted contact is permitted. • The therapist must make a clinical differentiation between a normative ambivalent response to previously forbidden and now permitted activity and the problematic use of modesty as a tool for maintaining distance or achieving control. As a consequence of these observances. This should be a focus of empathic understanding. there will have been no premarital physical contact with the opposite sex or any opportunity to see someone from the opposite sex not completely clothed. Although total nudity is the encouraged norm of marital sexuality. S. including not passing items from hand to hand or not drinking from the same cup. • In line with this. The therapist must take into consideration the tolerance levels of both spouses and the time each will need to gain comfort and mastery of new expectations regarding the removal of clothing and the treatment protocols for mutual touching. it is no longer a therapeutic context but the focus of therapy itself. the experience of being unclothed or being with someone in the same state may be an ongoing source of discomfort. Therapists must expect fear of new sexual experience and its implications for various levels of intimacy and openness among those for whom nudity with another. Such lines may be finely drawn. Ribner focus while maintaining Haredi values can be more readily accomplished under the following conditions: • For the overwhelming majority of Haredim. may have no personal paradigm. Downloaded By: [EBSCOHost EJS Content Distribution] At: 12:11 12 March 2009 Time Traditional Jewish law prohibits any physical contact between spouses during the days of menstruation and for a week after. necessitating consultation and possibly more direct involvement with a rabbinic authority to clarify religious boundaries.
however. . particularly of the opposite sex. There is little risk of a therapist “forcing” a phase into a too long or short of a time frame because the 2 weeks when touch is permitted presents a treatment option not an immutable standard. • The therapist should be sensitive to different guidelines related to norms of modest behavior for sexual communication between the two genders. the very language of sex therapy can raise a couple’s anxiety level when the initial goal is to lower it. we raise the following observations: • These regular breaks can serve as natural time boundaries separating one phase of treatment from the next and as a time for practicing without anxiety about coping with a looming next task. during some instances of prolonged vaginal bleeding).g. they can strive to achieve these simultaneous two aspects when touch is renewed and emphasize the genuineness of intimacy when physical contact is temporarily suspended. and sexual behaviors. as well as for providing an upper limit before a definite “off” time. I recommend the following: • Both spouses should agree upon a comfortable language of intimacy before beginning any actual contact exercise or at least before reaching a phase that involves erogenous areas. only a familiarity. several days of the previous phase of sensate focus should be repeated before going on to the next step. This will doubtless be a learning process for many therapists. at times with breaks lasting even longer than 2 weeks (e.Modifying Sensate Focus 169 sate focus will almost inevitably be interrupted.g. Jewish religious literature contains many metaphoric phrases to connote sexual organs and activities (e. this has somewhat been ameliorated through the use of premarital advisors to prepare brides and grooms for their sexual lives together. • When physical contact recommences.. Clients should be encouraged to use properly specific words with which they are most at ease. as well. For a therapist respecting the given structure. In recent years. Downloaded By: [EBSCOHost EJS Content Distribution] At: 12:11 12 March 2009 Communication Normative development and socialization within the Haredi community discourages the acquisition of language that specifically describes sexual organs. A couple experiencing the contrast between the two facets of a spousal relationship can integrate both. • The intervening days when physical contact is forbidden offers an opportunity to enhance the nonphysical aspects of marital intimacy. Even this educational advancement. This allows for an easier transition from a positive known experience to a possibly untried anxiety-provoking new one. “the organ” to mean penis and “that place” to mean vagina). does not seek to achieve a comfort level with sexual terms and norms.. Thus.
I direct couples to take no chances. an advanced stage of arousal. reciprocal. S. whereas men have more leeway in this regard. Although sensate focus is not designed to result in orgasm. and anger may be directed at the therapy and therapist and may lead to the couple ending treatment immediately. and on his wife’s willingness to do so. at least in the initial nongenital phases. We suggest a three-step approach to forestall a negative outcome: • Haredi couples initially should be given “permission” to engage in full sexual intercourse at any point during sensate focus exercises when the husband’s arousal may approach his control threshold. and culturally comfortable method for conveying and hearing sexual messages. Ejaculation As noted earlier. Helping couples create such an atmosphere can lower sexual expectations and avoid. it is essential that the couple be encouraged to confer with their rabbi before initiating treatment. with the option of rabbi-therapist consultation at any stage. As noted earlier. shame. Jewish tradition sees procreation as one of the two primary functions of sexual union. nonvaginal ejaculation. Ribner Haredi women are socialized to be less verbally explicit regarding their intimate desires and to make primary use of nonverbal cues. which generally produces a lowered state of anxiety. where the treatment of choice may require temporary ejaculation outside the vagina. This will be particularly important when dealing with problems such as retarded ejaculation. arousal may occur sufficient to reach ejaculatory inevitability. falls outside the category of acceptable sexual activity. the therapist should see this situation as a creative challenge in which all participants strive to achieve a clear. Such an intervention is predicated on the husband’s capacity to recognize his arousal pattern sufficiently to indicate when the squeeze should be done. • With the above in mind. the man’s resultant feelings of guilt. Should this occur. sexual satisfaction in marriage is deeply rooted in the fundamentals of Divine creation and accepted notions of how the universe . I have instructed couples in the use of the squeeze technique to reduce arousal and allow for the exercise to continue without the need for intercourse. as relaxing and pleasurable rather than as intense and sexual. Unless this code of behavior is expressly viewed as problematic by either spouse. it is useful to attempt to define these exercises. which prevents the possibility of pregnancy. • In several cases. or at least delay.170 D. Consequently. Downloaded By: [EBSCOHost EJS Content Distribution] At: 12:11 12 March 2009 CONCLUSION In the Haredi world.
New York: Brunner/Mazel. NJ: Jason Aronson. W. M. Bulletin of the Menninger Clinic. . W.. (1987). 266–278. T. In such situations. & Harrigan. V. A. However. 4. Geer & W. J. M. Federation of Jewish Philanthropies. The new sex therapy. Marital intimacy: A traditional Jewish approach. (1970). S. Family redeemed. 511–523. REFERENCES Bullis. (1992). Jehu. Friedman. P. Theories of human sexuality (pp. Brown. K. Families in Society: The Journal of Contemporary Human Services. & Johnson. Parrinder. New York: Wiley.). G. & Ramberg. mutual trust becomes a realistic objective. as an example of striving for perfection. (1974). Kaplan. 620–624. (1978). 21–48). 157. if essential values are respected. K. H. N. Human sexual inadequacy. Sex therapy with orthodox Jewish couples. Soloveitchik. respect. tolerance. P. (1997). Ostrov. The model that I suggest here is consistent with the norms and beliefs of my Haredi clients (and their rabbinic authorities) and may be adaptable as well to other traditional populations whose sexual values represent uncharted territory for clinicians. B. Consistent with this principle is the acknowledged responsibility of the couple to fix a faulty situation when needed. American Journal of Psychiatry. 304– 312.Modifying Sensate Focus 171 Downloaded By: [EBSCOHost EJS Content Distribution] At: 12:11 12 March 2009 should operate. (2000). Religious denominational policies on sexuality. New York: Commission on Synagogue Relations. Northvale. (1992). (1970). Journal of Sex & Marital Therapy. O’Donohue (Eds. J. In J. It is this context that allows professionals to be called upon when couples themselves reach a stage of frustrated helplessness. (2000). Simpson. a non-Haredi therapist working with Haredi clients confronts a dual challenge: earning the trust of this somewhat insular community and adapting intervention techniques that pose no threat to its values. The influence of religion on sexuality: Implications for sex therapy. Boston: Little. Masters. Linzer. 73. 56. Clearly. Sexual dysfunction. & Rudolph. V. A theological approach. S. Treating an orthodox Jewish woman with obsessive-compulsive disorder: Maintaining reproductive and psychologic stability in the context of normative religious rituals.. (1979). R. Burt. D. The Jewish family: A compendium.. New York: Plenum Press. and creativity will enable the clinician to assist without compromising the integrity of any participants in the therapeutic process. A. New York: Toras HoRav Foundation. S. H.
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